Individual
DR. TRACEY REILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
46 FAIRVIEW AVE, SKOWHEGAN, ME 04976-1481
(207) 474-5121
(207) 474-3441
Mailing address
PO BOX 468, SKOWHEGAN, ME 04976-0468
(207) 858-8353
(207) 474-9261
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0101238130
VA
207P00000X
Emergency Medicine Physician
235296
NY
207P00000X
Emergency Medicine Physician
Primary
MD20760
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02676364
—
NY
05
—
1639196264
—
ME
Enumeration date
07/17/2006
Last updated
03/22/2017
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